The coronavirus pandemic presents many uncertainties.  The two most critical uncertainties are how many Americans will die from the disease and what effect draconian preventive measures will have on the nation.  Of these two uncertainties, we have a much better handle the virus's mortality rate (which is low in absolute numbers) than we do on the social and economic effects of aggressive responses.  Logic and reason suggest that mitigating the larger economic and societal uncertainties should take precedence over the known and manageable risk of the virus itself. 

There's an additional argument that the impact of even a low-mortality disease like the coronavirus will wreck the medical system.  But reducing strains on one aspect of the economy isn't sufficient justification for shutting down the rest it.  That might convince pundits, politicians, and (quite naturally) health care providers, but not so much the population in general.  People are primarily concerned about whether they or their loved ones are vulnerable to the virus, not whether there are sufficient ICU beds.  And prioritizing one social need over others is a judgment call, not a necessary one.

The bottom line comes down to the balance between the disease's deadliness and the damage mitigating that number will do to the country overall.  We roughly know the parameters of the coronavirus's deadliness but not what damage dramatic mitigation will do. 

Throughout the pandemic, we have been inundated with scare stories regarding the ominous "worst case" scenario.  The most influential scenario upon which much American and European policy is based came from Dr. Neil Ferguson, a British academic who predicted up to 2.2 million American deaths in the worst case, 1.1 million in the best.  These estimates assumed an uncontrolled spread.  Whether due to mitigation efforts, uncertainty, or error, we can see that this prediction is clearly wrong.  Several weeks into the outbreak (at this writing), the U.S. has 655 deaths.  We are not going to reach anything like Ferguson's worst-case (or even best-case) scenario, or come close.  No reasonable authority can credibly now make such a claim.   

Currently, the most bruited new "worst case" scenario is Italy.  A projection published March 19 noted that the Italian mortality rate was twice that of Hubei province in China (which had China's highest death rate).  Extrapolating the Italian rate and relative populations, that translated into approximately 104,000 American deaths.  Since that article, the Italian death rate appears to have increased, but even assuming we double the estimate, that presents an upper end of 208,000 deaths from the coronavirus in the U.S.

Using Italy as our worst-case example, those deaths would be among the already sick or elderly.  The median age of Italian deaths is 80.  Approximately, only 1% of fatalities have occurred in people under 50 in Italy.  While sad, this population is always vulnerable to disease, is not active in the workforce, and is one for which societies traditionally accept high fatality rates. 

Moreover, there really is no reason to believe that the U.S. will suffer anything like Italian losses.  Italy's population is older than ours and smokes more.  Italy is more densely populated and effectively had a huge pipeline of infected Chinese people entering the country at the start of the outbreak, which China is now actively trying to cover up.  And the Italian death rate appears to be stabilizing and on the road to decline.  

Thus, we know within reasonable parameters the probable human cost of the virus in the U.S.  It will be much less than 0.01% of the U.S. population, concentrated overwhelmingly among the old and infirm.  This is not meant to disregard or disrespect individual and family costs, but these are constant in every society.  Regardless of the coronavirus, approximately 2.8 million Americans will die this year from all causes. 

Against these known parameters of loss are the economic and societal effects of the near shutdown of social and economic activity in the country.  Unlike the viral outbreak, the effects of this sudden and ongoing disruption of life are unknown, with at minimum an unprecedented effect on GDP.

At the current rate, many small businesses may fail permanently.  Many laid off workers may not quickly or ever find comparable employment.  People will suffer psychologically or abuse each other or drugs, gambling, pornography, and other vices.  Marriages will fail, children will fall behind educationally and otherwise, and consumer behavior will be altered for a generation.  Demand may recover, but it may not.  These societal and economic outcomes are not foreordained, but we just do not know.

If you have two doors to choose from, and behind one is a bad but limited and known danger, and behind the other is a bad but completely unknown one, you choose limited risk.  We know the limit of cost for the coronavirus itself.  We don't know costs of the cure.  An Easter opening is critical.

Image: Carsten Tolkmit via Flickr.